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Thyroid cancer

Tumor - thyroid; Cancer - thyroid; Nodule - thyroid cancer; Papillary thyroid carcinoma; Medullary thyroid carcinoma; Anaplastic thyroid carcinoma; Follicular thyroid cancer

 

Thyroid cancer is a cancer that starts in the thyroid gland. The thyroid gland is located inside the front of your lower neck.

Causes

 

Thyroid cancer can occur in people of any age.

Radiation increases the risk of developing thyroid cancer. Exposure may occur from:

  • Radiation therapy to the neck (especially in childhood)
  • Radiation exposure from nuclear plant disasters

Other risk factors are a family history of thyroid cancer and chronic goiter (enlarged thyroid).

There are several types of thyroid cancer:

  • Anaplastic carcinoma (also called giant and spindle cell cancer) is the most dangerous form of thyroid cancer. It is rare, and spreads quickly.
  • Follicular tumor is more likely to come back and spread.
  • Medullary carcinoma is a cancer of non-thyroid cells that are normally present in the thyroid gland. This form of thyroid cancer tends to occur in families.
  • Papillary carcinoma is the most common type, and it usually affects women of childbearing age. It spreads slowly and is the least dangerous type of thyroid cancer.

 

Symptoms

 

Symptoms vary depending on the type of thyroid cancer, but may include:

  • Cough
  • Difficulty swallowing
  • Enlargement of the thyroid gland
  • Hoarseness or changing voice
  • Neck swelling
  • Thyroid lump (nodule)

 

Exams and Tests

 

Your health care provider will perform a physical exam. This may reveal a lump in the thyroid, or swollen lymph nodes in the neck.

The following tests may be done:

  • Calcitonin blood test to check for medullary thyroid cancer
  • Laryngoscopy (looking inside the throat using a mirror or flexible tube called a laryngoscope placed through the mouth)
  • Thyroid biopsy
  • Thyroid scan
  • TSH, free T4 (blood tests for thyroid function)
  • Ultrasound of the thyroid
  • CT scan of the neck (to determine the extent of the cancerous mass)
  • PET scan

 

Treatment

 

Treatment depends on the type of thyroid cancer. Treatment of most thyroid cancer types is effective if diagnosed early.

Surgery is most often done. The entire thyroid gland is usually removed. If your provider suspects that the cancer has spread to lymph nodes in the neck, these will also be removed.

Radiation therapy may be done with or without surgery. It may be performed by:

  • Aiming external beam (x-ray) radiation at the thyroid
  • Taking radioactive iodine by mouth

After treatment for thyroid cancer, you must take thyroid hormone pills for the rest of your life. The dosage is usually slightly higher than what your body needs. This helps keep the cancer from coming back. The pills also replace the thyroid hormone your body needs to function normally.

If the cancer does not respond to surgery or radiation, and has spread to other parts of the body, chemotherapy or targeted therapy may be used. These are only effective for a small number of people.

 

Support Groups

 

You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone.

 

Possible Complications

 

Complications of thyroid cancer may include:

  • Injury to the voice box and hoarseness after thyroid surgery
  • Low calcium level from accidental removal of the parathyroid glands during surgery
  • Spread of the cancer to the lungs, bones, or other parts of the body

 

When to Contact a Medical Professional

 

Call your provider if you notice a lump in your neck.

 

Prevention

 

There is no known prevention. Awareness of risk (such as previous radiation therapy to the neck) can allow earlier diagnosis and treatment.

Sometimes, people with family histories and genetic mutations related to thyroid cancer will have their thyroid gland removed to prevent cancer.

 

 

References

Kim M, Ladenson PW. Thyroid. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 226.

National Cancer Institute website. Thyroid cancer treatment (adult) (PDQ) - health provisional version. www.cancer.gov/cancertopics/pdq/treatment/thyroid/HealthProfessional. Updated February 1, 2018. Accessed March 22, 2018.

Smith PW, Hanks LR, Salomone LJ, Hanks JB. Thyroid. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 36.

Thompson LDR. Malignant neoplasms of the thyroid gland. In: Thompson LDR, Bishop JA, eds. Head and Neck Pathology. 3rd ed. Philadelphia, PA: Elsevier; 2019:chap 25.

Text only

 
  • Endocrine glands

    Endocrine glands - illustration

    Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the rate of metabolism in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).

    Endocrine glands

    illustration

  • Thyroid cancer - CT scan

    Thyroid cancer - CT scan - illustration

    This CT scan of the upper chest (thorax) shows a malignant thyroid tumor (cancer). The dark area around the trachea (marked by the white U-shaped tip of the respiratory tube) is an area where normal tissue has been eroded and died (necrosis) as a result of tumor growth.

    Thyroid cancer - CT scan

    illustration

  • Thyroid cancer - CT scan

    Thyroid cancer - CT scan - illustration

    This CT scan shows a thyroid cancer tumor in the throat, encircling, narrowing, and displacing the windpipe (trachea).

    Thyroid cancer - CT scan

    illustration

  • Incision for thyroid gland surgery

    Incision for thyroid gland surgery - illustration

    The thyroid is a gland located in the neck. It is a part of the endocrine (hormone) system, and plays a major role in regulating the body's metabolism. If surgery or an open excisional biopsy is needed, an incision is made in front of the neck to gain access to the thyroid gland.

    Incision for thyroid gland surgery

    illustration

  • Thyroid gland

    Thyroid gland - illustration

    The thyroid gland, a part of the endocrine (hormone) system, plays a major role in regulating the body's metabolism.

    Thyroid gland

    illustration

    • Endocrine glands

      Endocrine glands - illustration

      Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the rate of metabolism in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).

      Endocrine glands

      illustration

    • Thyroid cancer - CT scan

      Thyroid cancer - CT scan - illustration

      This CT scan of the upper chest (thorax) shows a malignant thyroid tumor (cancer). The dark area around the trachea (marked by the white U-shaped tip of the respiratory tube) is an area where normal tissue has been eroded and died (necrosis) as a result of tumor growth.

      Thyroid cancer - CT scan

      illustration

    • Thyroid cancer - CT scan

      Thyroid cancer - CT scan - illustration

      This CT scan shows a thyroid cancer tumor in the throat, encircling, narrowing, and displacing the windpipe (trachea).

      Thyroid cancer - CT scan

      illustration

    • Incision for thyroid gland surgery

      Incision for thyroid gland surgery - illustration

      The thyroid is a gland located in the neck. It is a part of the endocrine (hormone) system, and plays a major role in regulating the body's metabolism. If surgery or an open excisional biopsy is needed, an incision is made in front of the neck to gain access to the thyroid gland.

      Incision for thyroid gland surgery

      illustration

    • Thyroid gland

      Thyroid gland - illustration

      The thyroid gland, a part of the endocrine (hormone) system, plays a major role in regulating the body's metabolism.

      Thyroid gland

      illustration

    A Closer Look

     

      Talking to your MD

       

        Self Care

         

          Tests for Thyroid cancer

           
           

          Review Date: 1/19/2018

          Reviewed By: Richard LoCicero, MD, private practice specializing in hematology and medical oncology, Longstreet Cancer Center, Gainesville, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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